Objective:To compare the embryo development potential and clinical outcomes between the patients with and without oocyte degeneration.Methods:This retrospective cohort study included a total of 242 cycles underwent ICSI that cultured in time-lapse incubator from January 2019 to June 2023 at the Reproductive and Genetic Center of Suzhou Municipal Hospital and all 3 119 oocytes were evaluated. Data collection continued to February 5th,2024 until the last birthing of the study. Patients were divided into degenerated group (140 cycles) and control group (102 cycles) according to whether oocyte degenerated after ICSI. Then the embryo developmental potential and clinical outcomes were compared. Furthermore, we also investigated whether embryo morphokinetics could be different between the two groups.Results:Female age, duration of infertility, body mass index, basal follicle sitmulating hormone, basal luteinizing hormone, basal estrogen (E 2), antral follicle count, anti-Müllerian hormone, factors of infertility and source of semen were similar between the two groups ( P>0.05). E 2 on human chorionic gonadotropin triggered day [2 513.00 (1 842.20, 3 638.50) ng/L], number of oocytes retrieved (13.56±4.80) and oocyte maturation rate [84.35% (1 601/1 898)] were significantly higher in degenerated group than those in control group [2 270.50 (1 472.00, 3 044.20) ng/L, P=0.019; 11.97±4.71, P=0.011; 81.08% (990/1 221), P=0.017], while normal fertilization rate [69.33% (1 103/1 591)], day 3 (D3) good-quality embryos [57.85% (634/1 096)], blastocyst formation rate [50.87% (469/922)] and embryo utilized rate [58.30% (643/1 103)] were significantly lower in degenerated group than those in control group [85.56% (847/990), P<0.001; 65.72% (556/846), P<0.001; 61.26% (446/728), P<0.001; 66.12% (560/847), P<0.001] . In addition, the proportion of low cell number (<7) of D3 embryos [33.76% (370/1 096)] and high fragmentation (fragmentation ≥50%, fragmentation 20%-50%) of D3 embryos [10.01% (109/1 089), 18.64% (203/1 089)] in degenerated group were significantly higher than those in control group [27.19% (230/846), P=0.002; 6.06% (51/841), P=0.002; 14.15% (119/841), P=0.009], and so were the incidence of DC1 and CC [5.98% (66/1 103) vs. 2.48% (21/847), P<0.001; 2.45% (27/1 103) vs. 0.94% (8/847), P=0.013]. As regard to the utilized embryos, there were no significant differences in t5, cc2, cc3 and s2 ( P>0.05), but tPNf [22.82(21.13, 24.84) h], t2 [25.37 (23.62, 27.37) h], t3 [35.64 (33.10, 38.03) h] and t4 [36.85 (34.70, 39.52) h] in degenerated group were significantly earlier than those in control group [23.04 (21.76, 25.41) h, P=0.001; 25.91 (24.15, 28.05) h, P=0.001; 36.16 (33.11, 38.81) h, P=0.040; 37.39 (35.11, 40.27) h, P=0.026]. Further more, after the first transfer of fresh or frozen embryos, there were no significant differences in clinical pregnancy rate, implantation rate, early abortion rate, live birth rate, sex ratio, preterm birth rate, low birth weight rate and birth defect rate between the two groups (all P>0.05). ICSI degeneration was not an independent factor of implantation rate, early abortion rate and live birth rate after ICSI treatment, but number of embryos transferred was an independent factor of implantation rate and live birth rate after ICSI treatment ( OR=2.806, 95% CI: 1.179-6.677, P=0.020; OR=2.622, 95% CI: 1.129-6.090, P=0.025). Conclusion:The presence of oocyte degeneration after ICSI may affect the overall developmental potential of its sibling oocytes and may also disturb the morphokinetics of the embyos, however the pregnancy outcomes and neonatal birth outcomes may not be affected if transfer the best embryo in the first fresh or frozen cycle.

Objective:To understand the prevalence and related factors of three common chronic diseases, hyperlipidemia, hypertension and diabetes in HIV-infected persons.Methods:As of December 2023, HIV-infected persons >15 years old who are receiving antiviral therapy (ART) and follow-up in Henan Province were selected as the study objects. Questionnaires, physical examinations, and blood samples were collected to collect demographic information, ART, body weight, blood lipids, blood pressure, and blood sugar of HIV-infected persons. The logistic regression model was used to analyze the related factors of hyperlipidemia, hypertension and diabetes.Results:Among 4 023 HIV-infected patients, the prevalence rates of hyperlipidemia, hypertension, and diabetes were 64.47% (2 594/4 023), 16.80% (676/4 023), and 10.54% (424/4 023), respectively. Multivariate analysis showed that hyperlipidemia was positively associated with ≥40 years of age, overweight and obesity, two nucleoside reverse transcriptase inhibitors (NRTIs) + proteasome inhibitors (PIs) regimen and two NRTIs+ integrase inhibitor regimen, and negatively associated with low body weight. Hypertension was positively correlated with the age group ≥40 years old, family history of cardiovascular and cerebrovascular diseases, overweight and obesity, ART time ≥0.5 years, and negatively correlated with low body weight. Diabetes was positively associated with age group ≥40 years, family history of cardiovascular and cerebrovascular disease, overweight and obesity, and negatively associated with the use of two NRTIs+PIs treatment regimens.Conclusions:In 2023, the prevalence of hyperlipidemia, hypertension, and diabetes among HIV-infected people in Henan Province was relatively high, and the risk of common chronic diseases among those ≥40 years old, overweight and obese, and those with a family history of cardiovascular and cerebrovascular diseases was also relatively high. It is recommended to strengthen the prevention and management of common chronic diseases among HIV-infected people.

Objective:To compare the embryo development potential and clinical outcomes between the patients with and without oocyte degeneration.Methods:This retrospective cohort study included a total of 242 cycles underwent ICSI that cultured in time-lapse incubator from January 2019 to June 2023 at the Reproductive and Genetic Center of Suzhou Municipal Hospital and all 3 119 oocytes were evaluated. Data collection continued to February 5th,2024 until the last birthing of the study. Patients were divided into degenerated group (140 cycles) and control group (102 cycles) according to whether oocyte degenerated after ICSI. Then the embryo developmental potential and clinical outcomes were compared. Furthermore, we also investigated whether embryo morphokinetics could be different between the two groups.Results:Female age, duration of infertility, body mass index, basal follicle sitmulating hormone, basal luteinizing hormone, basal estrogen (E 2), antral follicle count, anti-Müllerian hormone, factors of infertility and source of semen were similar between the two groups ( P>0.05). E 2 on human chorionic gonadotropin triggered day [2 513.00 (1 842.20, 3 638.50) ng/L], number of oocytes retrieved (13.56±4.80) and oocyte maturation rate [84.35% (1 601/1 898)] were significantly higher in degenerated group than those in control group [2 270.50 (1 472.00, 3 044.20) ng/L, P=0.019; 11.97±4.71, P=0.011; 81.08% (990/1 221), P=0.017], while normal fertilization rate [69.33% (1 103/1 591)], day 3 (D3) good-quality embryos [57.85% (634/1 096)], blastocyst formation rate [50.87% (469/922)] and embryo utilized rate [58.30% (643/1 103)] were significantly lower in degenerated group than those in control group [85.56% (847/990), P<0.001; 65.72% (556/846), P<0.001; 61.26% (446/728), P<0.001; 66.12% (560/847), P<0.001] . In addition, the proportion of low cell number (<7) of D3 embryos [33.76% (370/1 096)] and high fragmentation (fragmentation ≥50%, fragmentation 20%-50%) of D3 embryos [10.01% (109/1 089), 18.64% (203/1 089)] in degenerated group were significantly higher than those in control group [27.19% (230/846), P=0.002; 6.06% (51/841), P=0.002; 14.15% (119/841), P=0.009], and so were the incidence of DC1 and CC [5.98% (66/1 103) vs. 2.48% (21/847), P<0.001; 2.45% (27/1 103) vs. 0.94% (8/847), P=0.013]. As regard to the utilized embryos, there were no significant differences in t5, cc2, cc3 and s2 ( P>0.05), but tPNf [22.82(21.13, 24.84) h], t2 [25.37 (23.62, 27.37) h], t3 [35.64 (33.10, 38.03) h] and t4 [36.85 (34.70, 39.52) h] in degenerated group were significantly earlier than those in control group [23.04 (21.76, 25.41) h, P=0.001; 25.91 (24.15, 28.05) h, P=0.001; 36.16 (33.11, 38.81) h, P=0.040; 37.39 (35.11, 40.27) h, P=0.026]. Further more, after the first transfer of fresh or frozen embryos, there were no significant differences in clinical pregnancy rate, implantation rate, early abortion rate, live birth rate, sex ratio, preterm birth rate, low birth weight rate and birth defect rate between the two groups (all P>0.05). ICSI degeneration was not an independent factor of implantation rate, early abortion rate and live birth rate after ICSI treatment, but number of embryos transferred was an independent factor of implantation rate and live birth rate after ICSI treatment ( OR=2.806, 95% CI: 1.179-6.677, P=0.020; OR=2.622, 95% CI: 1.129-6.090, P=0.025). Conclusion:The presence of oocyte degeneration after ICSI may affect the overall developmental potential of its sibling oocytes and may also disturb the morphokinetics of the embyos, however the pregnancy outcomes and neonatal birth outcomes may not be affected if transfer the best embryo in the first fresh or frozen cycle.

Objective:To understand the prevalence and related factors of three common chronic diseases, hyperlipidemia, hypertension and diabetes in HIV-infected persons.Methods:As of December 2023, HIV-infected persons >15 years old who are receiving antiviral therapy (ART) and follow-up in Henan Province were selected as the study objects. Questionnaires, physical examinations, and blood samples were collected to collect demographic information, ART, body weight, blood lipids, blood pressure, and blood sugar of HIV-infected persons. The logistic regression model was used to analyze the related factors of hyperlipidemia, hypertension and diabetes.Results:Among 4 023 HIV-infected patients, the prevalence rates of hyperlipidemia, hypertension, and diabetes were 64.47% (2 594/4 023), 16.80% (676/4 023), and 10.54% (424/4 023), respectively. Multivariate analysis showed that hyperlipidemia was positively associated with ≥40 years of age, overweight and obesity, two nucleoside reverse transcriptase inhibitors (NRTIs) + proteasome inhibitors (PIs) regimen and two NRTIs+ integrase inhibitor regimen, and negatively associated with low body weight. Hypertension was positively correlated with the age group ≥40 years old, family history of cardiovascular and cerebrovascular diseases, overweight and obesity, ART time ≥0.5 years, and negatively correlated with low body weight. Diabetes was positively associated with age group ≥40 years, family history of cardiovascular and cerebrovascular disease, overweight and obesity, and negatively associated with the use of two NRTIs+PIs treatment regimens.Conclusions:In 2023, the prevalence of hyperlipidemia, hypertension, and diabetes among HIV-infected people in Henan Province was relatively high, and the risk of common chronic diseases among those ≥40 years old, overweight and obese, and those with a family history of cardiovascular and cerebrovascular diseases was also relatively high. It is recommended to strengthen the prevention and management of common chronic diseases among HIV-infected people.

Meningococcal polysaccharide conjugate vaccine is basically produced by chemical combination,and the most commonly used method is amide condensation reaction.Because of the covalent bonds between polysaccharide and protein,the prepared conjugate vaccine has high stability and good technical advantages,which plays an important role in the prevention of meningococcal related diseases.The vaccine can be applied to the immunization of young children under 2years old,and has more lasting protective effect.In this paper,the factors influencing the preparation of meningococcal polysaccharide conjugate vaccine,the binding mode of polysaccharide and carrier protein,the present situation at home and abroad and the existing problems in the preparation process were reviewed.

Objective:To analyse the clinical significance of selective single embryo transfer by time-lapse mo-nitoring(TLM)or conventional morphology assessment(CMA)in vitro fertilization/intracytoplasmic sperm in-jection and embryo transfer(IVF/ICSI-ET),and to initially explore the predictive value of Raman spectral analy-sis of embryo culture medium for clinical pregnancy rate.Methods:The study is a prospective randomized con-trolled clinical trial.We assigned 139 patients treated with IVF/ICSI-ET in Reproductive and Genetics Center of Suzhou Municipal Hospital from April 2019 to July 2020,which were randomly assigned to either the CMA or the TLM group.We performed selective single-embryo transfer(fresh cycle and FET)after selecting the optimal em-bryos with TLM or CMA respectively.If the patient's first embryo transfer was unsuccessful,a second one would be performed to compare the differences in the cumulative live birth rate of embryo transfer and other pregnancy outcomes between the two groups.Meanwhile,we collected 15 μl of embryo culture medium at day 3 after IVF/ISCI fertilization for Raman spectroscopy analysis.Results:There were no differences in cumulative live birth,cu-mulative clinical pregnancy,cumulative premature birth,cumulative early spontaneous abortion,cumulative ectopic pregnancy and LGA or SGA between TLM and CMA groups(P＞0.05).The Neonatal sex ratio in the TLM group was lower than that in the CMA group,but the difference was not significant(P＞0.05).Raman spectros-copy analysis of embryo culture medium predicted the clinical pregnancy rate with 67.21％accuracy.Conclu-sions:In young women with a good ovarian reserve,the advantage of using TLM to evaluate embryos is not obvi-ous,so we should remain vigilant that embryo selection based on morphokinetic parameters may affect the sex ratio.Raman spectroscopic analysis of embryo culture medium is not yet able to effectively predict the planting ability of embryos.

Meningococcal polysaccharide conjugate vaccine is basically produced by chemical combination,and the most commonly used method is amide condensation reaction.Because of the covalent bonds between polysaccharide and protein,the prepared conjugate vaccine has high stability and good technical advantages,which plays an important role in the prevention of meningococcal related diseases.The vaccine can be applied to the immunization of young children under 2years old,and has more lasting protective effect.In this paper,the factors influencing the preparation of meningococcal polysaccharide conjugate vaccine,the binding mode of polysaccharide and carrier protein,the present situation at home and abroad and the existing problems in the preparation process were reviewed.

BACKGROUND: Numerous researches indicated that electromagnetic pulses (EMP) possessed advantages such as strong targeting, minimal side-effects and low treatment cost in tumor therapy, but its optimum parameters for treatment and the relationship between EMP and tumor-derived exosomes remains unclear. This study aims to clarify the effects of EMP with different parameters on the quantity and miRNA (microRNA) of exosomes secreted by human non-small cell lung cancer A549 cells, providing beneficial reference for the clinical application of EMP and related research. METHODS: A549 cells were randomly divided into control group and different EMP radiation groups with respective intensity of 400, 600 and 800 kV/m. EMP was performed with 2000 pulses once, 20 Hz of repetition frequency and 120 ns of pulse width. A549 cells were radiated once per day for continuous 3 days. After radiation, exosomes were collected and identified; cell number was measured by trypan blue staining; the concentration of exosomes was measured by nanoparticle tracking analysis (NTA); the abundance of miRNAs was determined by miRNA sequencing. RESULTS: Compared with control group, the morphology and cell viability of A549 cells in radiation group was not different, but the quantity of exosomes in 400 or 800 kV/m radiation group was significantly decreased (P<0.05), in contrast with obvious increase in 600 kV/m radiation group (P<0.05). The abundance of exosomal miRNAs between control group and each EMP group was obviously different (P<0.05) and target genes of differentially abundant miRNAs enriched in different pathways. CONCLUSIONS Under the experimental condition, the quantity and miRNA abundance of exosomes could be changed by EMP radiation, which could further influence the function of tumor-derived exosomes.
Humans ; Exosomes/genetics* ; A549 Cells ; MicroRNAs/metabolism* ; Lung Neoplasms/pathology* ; Cell Survival/radiation effects* ; Electromagnetic Fields

Objective:To explore the effects of human chorionic gonadotropin (hCG), progesterone as well as the change of estradiol 12 h after hCG trigger on the outcomes of in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET). Methods:A retrospective study was conducted at the Center for Reproduction and Genetics of the Affiliated Suzhou Hospital of Nanjing Medical University. A total of 2 506 patients received IVF/ICSI-ET treatment with gonadotropin-releasing hormone agonist (GnRH-a) protocol from March 2015 to June 2020 were selected. With Spearman rank correlation analysis and path analysis, we explore the relationship among the changes of these hormones and the baseline characteristic of patients, as well as the relationship among the changes of these hormones and the outcomes of IVF treatment.Results:The increase of hCG was accompanied by the rise of progesterone and the decline of estradiol change rate ( r=0.094, P<0.001; r=-0.093, P<0.001). Meanwhile the rise of progesterone was accompanied by the decline of estradiol change rate ( r=-0.089, P<0.001). The dosage of hCG trigger was directly positively correlated to hCG level after hCG trigger, path coefficients (PC) was 0.307 ( P<0.001). Body mass index (BMI) was directly negatively correlated to hCG level and progesterone level after hCG trigger (PC=-0.434, P<0.001; PC=-0.154, P<0.001), whereas positively correlated to estradiol change rate (PC=0.097, P<0.001). Meanwhile the duration and dosage of gonadotropin (Gn) used were positively correlated to progesterone level after hCG trigger (PC=0.102, P<0.001; PC=0.080, P=0.030). hCG level and progesterone level after hCG trigger had positive correlation to oocyte retrieved rate (PC=0.098, P<0.001; PC=0.080, P<0.001). While estradiol change rate was not correlated to oocyte retrieved rate ( P>0.05). Progesterone level on hCG trigger day negatively related to normal fertilization rate (PC=-0.050, P=0.039). hCG level, progesterone level and estradiol change rate after hCG trigger had no correlation with high-quality embryo rate, clinical pregnancy rate and live birth rate (all P>0.05). Conclusion:Oocyte retrieved rate was positively affected by hCG level and progesterone level 12 h after hCG trigger. While normal fertilization rate, high-quality embryo rate, clinical pregnancy rate and live birth rate were not affected by the change of hormones level 12 h after hCG trigger. Therefore we should pay attention to hCG level and progesterone level 12 h after hCG trigger.

The role of microbiota in human reproduction has become the “the second genome of humanity”. In fact, more and more researches have investigated the microbiota in reproduction, including the lower and upper reproductive tracts, and even the interactions with gametogenesis. The microbiota not only plays a crucial role in the pathological states caused by health and microecological disorders, but may also play an important role in successful fertilization and healthy pregnancy. Currently, researches on the relationship between microbiota and human reproductive axis are attracting widespread attention. This article reviews the impact of microbiota on reproductive outcomes, as well as the impact and possible mechanisms of microbiota in the uterine cavity on immune tolerance. It explores that dysbiosis of microbiota may play a role through immune tolerance. This may play a guiding role in regulating the microecology and exploring new methods for treating reproductive diseases.